Risk factors for cardiovascular disease across the spectrum of older age: The Cardiovascular Health Study

Michelle C. Odden, Michael G. Shlipak, Heather E. Whitson, Ronit Katz, Patricia M. Kearney, Chris Defilippi, Shani Shastri, Mark J. Sarnak, David S. Siscovick, Mary Cushman, Bruce M. Psaty, Anne B. Newman

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Objective: The associations of some risk factors with cardiovascular disease (CVD) are attenuated in older age whereas others appear robust. The present study aimed to compare CVD risk factors across older age. Methods: Participants (. n=4883) in the Cardiovascular Health Study free of prevalent CVD, were stratified into three age groups: 65-74, 75-84, 85+ years. Traditional risk factors included systolic blood pressure (BP), LDL-cholesterol, HDL-cholesterol, obesity, and diabetes. Novel risk factors included kidney function, C-reactive protein (CRP), and N-terminal pro-B-type natriuretic peptide (NT pro-BNP). Results: There were 1498 composite CVD events (stroke, myocardial infarction, and cardiovascular death) over 5 years. The associations of high systolic BP and diabetes appeared strongest, though both were attenuated with age (. p-values for interaction=0.01 and 0.002, respectively). The demographic-adjusted hazard ratios (HR) for elevated systolic BP were 1.79 (95% confidence interval: 1.49, 2.15), 1.59 (1.37, 1.85) and 1.10 (0.86, 1.41) in participants aged 65-74, 75-84, 85+, and for diabetes, 2.36 (1.89, 2.95), 1.55 (1.27, 1.89), 1.51 (1.10, 2.09). The novel risk factors had consistent associations with the outcome across the age spectrum; low kidney function: 1.69 (1.31, 2.19), 1.61 (1.36, 1.90), and 1.57 (1.16, 2.14) for 65-74, 75-84, and 85+ years, respectively; elevated CRP: 1.54 (1.28, 1.87), 1.33 (1.13, 1.55), and 1.51 (1.15, 1.97); elevated NT pro-BNP: 2.67 (1.96, 3.64), 2.71 (2.25, 3.27), and 2.18 (1.43, 3.45). Conclusions: The associations of most traditional risk factors with CVD were minimal in the oldest old, whereas diabetes, eGFR, CRP, and NT pro-BNP were associated with CVD across older age.

Original languageEnglish (US)
Pages (from-to)336-342
Number of pages7
JournalAtherosclerosis
Volume237
Issue number1
DOIs
StatePublished - Nov 1 2014

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Cardiovascular Diseases
Brain Natriuretic Peptide
Blood Pressure
Health
C-Reactive Protein
Kidney
LDL Cholesterol
HDL Cholesterol
Age Groups
Obesity
Stroke
Myocardial Infarction
Demography
Confidence Intervals
Hypertension

Keywords

  • Aging
  • Epidemiology
  • Risk factors

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Odden, M. C., Shlipak, M. G., Whitson, H. E., Katz, R., Kearney, P. M., Defilippi, C., ... Newman, A. B. (2014). Risk factors for cardiovascular disease across the spectrum of older age: The Cardiovascular Health Study. Atherosclerosis, 237(1), 336-342. https://doi.org/10.1016/j.atherosclerosis.2014.09.012

Risk factors for cardiovascular disease across the spectrum of older age : The Cardiovascular Health Study. / Odden, Michelle C.; Shlipak, Michael G.; Whitson, Heather E.; Katz, Ronit; Kearney, Patricia M.; Defilippi, Chris; Shastri, Shani; Sarnak, Mark J.; Siscovick, David S.; Cushman, Mary; Psaty, Bruce M.; Newman, Anne B.

In: Atherosclerosis, Vol. 237, No. 1, 01.11.2014, p. 336-342.

Research output: Contribution to journalArticle

Odden, MC, Shlipak, MG, Whitson, HE, Katz, R, Kearney, PM, Defilippi, C, Shastri, S, Sarnak, MJ, Siscovick, DS, Cushman, M, Psaty, BM & Newman, AB 2014, 'Risk factors for cardiovascular disease across the spectrum of older age: The Cardiovascular Health Study', Atherosclerosis, vol. 237, no. 1, pp. 336-342. https://doi.org/10.1016/j.atherosclerosis.2014.09.012
Odden, Michelle C. ; Shlipak, Michael G. ; Whitson, Heather E. ; Katz, Ronit ; Kearney, Patricia M. ; Defilippi, Chris ; Shastri, Shani ; Sarnak, Mark J. ; Siscovick, David S. ; Cushman, Mary ; Psaty, Bruce M. ; Newman, Anne B. / Risk factors for cardiovascular disease across the spectrum of older age : The Cardiovascular Health Study. In: Atherosclerosis. 2014 ; Vol. 237, No. 1. pp. 336-342.
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AU - Odden, Michelle C.

AU - Shlipak, Michael G.

AU - Whitson, Heather E.

AU - Katz, Ronit

AU - Kearney, Patricia M.

AU - Defilippi, Chris

AU - Shastri, Shani

AU - Sarnak, Mark J.

AU - Siscovick, David S.

AU - Cushman, Mary

AU - Psaty, Bruce M.

AU - Newman, Anne B.

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N2 - Objective: The associations of some risk factors with cardiovascular disease (CVD) are attenuated in older age whereas others appear robust. The present study aimed to compare CVD risk factors across older age. Methods: Participants (. n=4883) in the Cardiovascular Health Study free of prevalent CVD, were stratified into three age groups: 65-74, 75-84, 85+ years. Traditional risk factors included systolic blood pressure (BP), LDL-cholesterol, HDL-cholesterol, obesity, and diabetes. Novel risk factors included kidney function, C-reactive protein (CRP), and N-terminal pro-B-type natriuretic peptide (NT pro-BNP). Results: There were 1498 composite CVD events (stroke, myocardial infarction, and cardiovascular death) over 5 years. The associations of high systolic BP and diabetes appeared strongest, though both were attenuated with age (. p-values for interaction=0.01 and 0.002, respectively). The demographic-adjusted hazard ratios (HR) for elevated systolic BP were 1.79 (95% confidence interval: 1.49, 2.15), 1.59 (1.37, 1.85) and 1.10 (0.86, 1.41) in participants aged 65-74, 75-84, 85+, and for diabetes, 2.36 (1.89, 2.95), 1.55 (1.27, 1.89), 1.51 (1.10, 2.09). The novel risk factors had consistent associations with the outcome across the age spectrum; low kidney function: 1.69 (1.31, 2.19), 1.61 (1.36, 1.90), and 1.57 (1.16, 2.14) for 65-74, 75-84, and 85+ years, respectively; elevated CRP: 1.54 (1.28, 1.87), 1.33 (1.13, 1.55), and 1.51 (1.15, 1.97); elevated NT pro-BNP: 2.67 (1.96, 3.64), 2.71 (2.25, 3.27), and 2.18 (1.43, 3.45). Conclusions: The associations of most traditional risk factors with CVD were minimal in the oldest old, whereas diabetes, eGFR, CRP, and NT pro-BNP were associated with CVD across older age.

AB - Objective: The associations of some risk factors with cardiovascular disease (CVD) are attenuated in older age whereas others appear robust. The present study aimed to compare CVD risk factors across older age. Methods: Participants (. n=4883) in the Cardiovascular Health Study free of prevalent CVD, were stratified into three age groups: 65-74, 75-84, 85+ years. Traditional risk factors included systolic blood pressure (BP), LDL-cholesterol, HDL-cholesterol, obesity, and diabetes. Novel risk factors included kidney function, C-reactive protein (CRP), and N-terminal pro-B-type natriuretic peptide (NT pro-BNP). Results: There were 1498 composite CVD events (stroke, myocardial infarction, and cardiovascular death) over 5 years. The associations of high systolic BP and diabetes appeared strongest, though both were attenuated with age (. p-values for interaction=0.01 and 0.002, respectively). The demographic-adjusted hazard ratios (HR) for elevated systolic BP were 1.79 (95% confidence interval: 1.49, 2.15), 1.59 (1.37, 1.85) and 1.10 (0.86, 1.41) in participants aged 65-74, 75-84, 85+, and for diabetes, 2.36 (1.89, 2.95), 1.55 (1.27, 1.89), 1.51 (1.10, 2.09). The novel risk factors had consistent associations with the outcome across the age spectrum; low kidney function: 1.69 (1.31, 2.19), 1.61 (1.36, 1.90), and 1.57 (1.16, 2.14) for 65-74, 75-84, and 85+ years, respectively; elevated CRP: 1.54 (1.28, 1.87), 1.33 (1.13, 1.55), and 1.51 (1.15, 1.97); elevated NT pro-BNP: 2.67 (1.96, 3.64), 2.71 (2.25, 3.27), and 2.18 (1.43, 3.45). Conclusions: The associations of most traditional risk factors with CVD were minimal in the oldest old, whereas diabetes, eGFR, CRP, and NT pro-BNP were associated with CVD across older age.

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KW - Risk factors

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